John Goodman on Curing the Health Care Crisis

"The problem is that we've so completely surpressed the marketplace in healthcare that none of us ever sees a real price for anything," says economist John Goodman.

Reason magazine's Matt Welch sat down with Goodman at FreedomFest 2012 to discuss solutions to healthcare discussed in Goodman's book, "Priceless: Curing the Healthcare Crisis."

Held each July in Las Vegas, FreedomFest is attended by around 2,000 limited-government enthusiasts and libertarians a year. ReasonTV spoke with over two dozen speakers and attendees and will be releasing interviews over the coming weeks. For an ever-growing playlist, go here now:

About 4:11 minutes.

Camera by Tracy Oppenheimer and Alex Manning; edited by Paul Detrick.

[nanochase]

I work in retail and the price transparency, cutthroat competion, and massive choice make it something to behold. I wish other industries were like this, we would all be in much better situation. In the past two years I have seen our regular prices stedily go down across the board except for food but thats because the government pays for that on both ends.

[LibertyEver]

There is so much common sense in the approach of adopting private insurance and restoring proper price incentives to patients and health care providers, as opposed to the perverse system we have, but it's so frustrating that so many people bleat that health care is a fundamental human right, not recognizing that they're driving costs up and quality down.

Name one thing that government makes better or less expensive.

[SpergerKing]

My 2 favorite episodes are the ones that had Nick Gilespie on them. Both times he completely dominated the conversation and pissed everyone else off.

[nanochase]

I was making an example that massive innovation can happen in short amount of time. Moore's law has nothing to do with the manufacturing of LCD arrays, and yes competition did accomplish this. In our new world you compete by making your competion obsolete. Now back to healthcare, if restrictions were loosened from the FDA increasing the range of medical options to the public then market forces will lead to the cheapest fastest option so whoever innovates the next great medical advancement wins.

[dmg]

If it was a choice between US vs Singapore system today, I'd agree with you. However, the systems adopted in Singapore and Switzerland are still relatively new. It remains to be seen whether over time, a half&half system won't grow to become behemoth like the NHS.

Thus it might seem like a good idea TODAY, but a slippery slope that once embarked on would be impossible to remove short of federal default.

[Loathomar]

I didn't say "the BBC don't care about ratings", just that it is "under far less pressure to get ratings". The BBC can make the trade of losing some viewers to reasonable inform the views they have, a statement that the CEO of CBS, ABC or NBS would be fire for unless they could show that less views = higher or at least = profits. CEO's of public companies have a fiduciary responsibility to shareholders, which means they must work to maximize profits. That is not the goal of the BBC or PBS.

[nanochase]

Well the last bit I said as a joke, but I would like to see a detailed and feasible plan to begin the retail-ization of heathcare. Something similar has already been in place in cosmetic surgery and has led to huge price cuts and efficiencies over the past 20 years. A 60 inch TV used to be only available to the elites now you can get one for just $1000. Even the luxurious things become affordible in due time.

[dmg]

" Overall, household outof-pocket payments as a proportion of total national health care expenditures have
declined over time, from 30.3% in 1960, 17.6% in 1970, 12.8% in 1980, 11.4% in 1990,
7.1% in 2000, and 6.7% in 2006."... I don't know where you get 30% out of pocket healthcare in France?!?! The reduction in copay from political pressure is exactly the problem these half and half systems face...

[Loathomar]

French health system has people 100% of most services then refunds patients 70% of most health care costs, and 100% in case of costly or long-term ailments. Much of the changes between 1960 and 2006 is that 12.8% is now from by private insurance. It is kind of odd for people to have private insurance and not count that as out of pocket. Do you have the percents of government pays for as a percentage over the same time?

[Loathomar]

But it is basically the same as France or Switzerland. If Obama said he was going to pay for 70% of all healthcare, like Singapore, people would call it a single payer system. They would be wrong, but that is what people would call it. But this is the kind of system that the US needs, one that helps cover EVERYONE, while still getting people to make the right healthcare decisions because it is still their money they will need to spend.

[Redmond]

"And who is protecting those property rights? Yes, the government with its laws."

No, there is no govt in this hypothetical situation. While the only real purpose of government is to protect private property rights, government is not necessary to have private property.

Also, I see no justification to separate "personal" property from private property, so I will use the term "private property" to refer to both until further notice.

[Loathomar]

In the end, we already pay 18% of all US income to healthcare. If healthcare stays the same and we are paying the same price for it, why should anyone care if it is paid for by taxes, businesses or out of your pocket? The question is how do with improve efficiency and effectiveness for the US healthcare system. The US government is not known for its efficiency and effectiveness, which is why most people thing that they will do a poor job, thought the current state of health is really shitty.

[Loathomar]

Places like Switzerland and Singapore would still be thought of as very much single payer government for healthcare in the US. Both Switzerland and Singapore gov pays ~70% of all healthcare costs. But the 30% costs that is paid for by people is paid directly by people for medical care. So, when you have the choice between a $500 MRI or a $100 X-ray, you have to pay $150 or $30. And if there is not a good reason to pay the $150, people will take the $30. The same general idea is true for France.

[DrunkenGodMode]

Really, so you want to end the one thing that keeps the government out of our bedrooms, you do realize that the slow end to private property is a prime reason shit is going down hill.

[Loathomar]

Yes, American like the shows that show them "my view is right" rather then shows that make them question their beliefs. The BBC is under far less pressure to get ratings, and would rather make shows that reasonable inform their views and get lower rates. This is also true for PBS/NPR in the US, which showed Free to Choose. And currently shows like the news hour was not made for ratings, but to reasonable inform people about current events in the US and the world.

[dmg]

Singapore is hardly single payer. Even the poor pay 20% of the fees, as you get wealthier you pay more and more until you're basically paying it for yourself. Most people who advocate for single payer don't want people to think about costs. The Singapore government, in their construction of healthcare, were adamant that people thought about costs. This is entirely different from say the UK, where cost has basically been removed.

[obtree]

Right. Because the only person in the world with the completely unique name John Goodman is the actor. My tiny mind cannot comprehend a coincidence where another person has the same name as a famous person.

[Redmond]

Another analogy: If a man buys a 747 airliner and uses it solely for himself, selfishly refusing to let anybody ride along, regardless of payment offered, your logic dictates that to be "personal" property, and is perfectly fine. Yet if a group of people buy many 747s and offer people regular flights in exchange for payment, your logic dictates that to be "private" property and is somehow bad.

[dmg]

People should care HOW they pay for healthcare... whether it be taxes, businesses or out of pocket, because it effects the price of services!

Search for "Milton Friedman Health Care Reform" on youtube.

[Redmond]

You can't advocate big government socializing private property while simultaneously advocating having no government at all.